“When the sex listed on the birth certificate doesn’t match how a person presents themselves in society it opens the door for harassment and discrimination,” David Johnson, the state’s Department of Health public information officer, told KIRO Radio’s Dori Monson. “Giving people this option to have a birth certificate that aligns with their current gender identity reduces this risk and promotes health equity for all those folks born here in Washington.”

The proposed rule, which is similar to legislation passed in California, Oregon, and Washington, D.C, is not without controversy.

“A lot of folks had a lot of opinions regarding the issue,” Johnson said. “That was the point of us holding this public hearing. It was a chance to give people to voice their opinions, for and against.”

Johnson said the Department of Health will be considering the public comments it received at the hearing and in written form and making a recommendation to the Secretary of Health. A final decision is expected to be made by the end of the year. If approved, the rule would go into effect in late January or early February.

The proposed rule does not apply to gender designations made at the time of birth. Parents would not be able to list the sex of their newborn as “X.” Instead, it would allow Washington-born adults to request a change to their birth certificates to designate their gender as non-binary rather than as male or female.

That non-binary designation could be an “X” or it could be something else, Johnson said.

To date, Johnson said, there have been around 300 changes in sex designation in the state. Currently Washington residents are allowed to request a change on their birth certificate from male to female or from female to male. They might soon have a third option.

Despite opposition, Johnson stated that the rule is all about health equity.

“This rule is a rule not for the Department of Health but a rule for all Washingtonians,” he said. “Social norms today are different today than they were five years, ten years, fifteen or twenty years ago.”